Psychosocial wellbeing

On October 10, World Mental Health Day was marked all over the world, and the week after was termed the Mental Health Awareness Week. We should do this the rest of the year, too, keep up-to-date with the thinking about mental health issues and psychosocialwellbeing . It concerns us all.

This year, the theme was psychological first aid, drawing attention to what we all can do when terrible things happen in our local communities. It can be individual disasters affecting one or a few persons, or it can be accidents that affect many, caused by natural disasters, fires, building collapses, workplace accidents; or it can be man-made disasters, such as shooting situations in schools or markets, and indeed terrorist attacks.

The World Mental Health Day and Week focused on what we all can do to offer some kind of psychological first aid. It can be simple, pragmatic assistance and comfort to persons who are in distress, either they have been directly hit, or they have witnessed terrible things. Often, that means being available and simply talking to the person in distress, knowing what is right to say and do. But it also means giving more direct support and advice.

To be able to give psychological first aid, it helps if all citizens in a country have received some training and orientation in order to be prepared to act in case a disaster happens. Thus, schools, colleges and universities should give courses to students and staff; NGOs and employers should do the same; and local communities should have orientation and discussion meetings to prepare people before disasters happen. It is a fact that most of us will sooner or later find ourselves in situations where psychological first aid is required for friends or strangers, or we may be at the receiving end.

In Pakistan, we have had many accidents and disasters of all kinds, and people have done what they can to protect and help others; the police, guards and other security staff, firemen, health workers, local administration officials, teachers, NGO staff, and others who have taken immediate and impressive action. Much of this work can only be done by professionals, who are trained for the job. We should appreciate their selfless efforts, which is also risky to themselves.

After the earthquake in 2005, which hit Kashmir, Mansehra and neighbouring areas particularly hard, it was impressive to see how well many ordinary people responded. It was also noticed that in homes and communities where they had lost their women, men were less able to cope. It is a fact that in many cases, women are the social workers in homes, without knowing it or receiving recognition for it. But we live in a time of gender equality, so men to need to take more part in these issues, and we all need to learn more about how to provide psychosocial first aid.

Furthermore, this year’s Mental Health Day and Week also drew attention to the situation of refugees and other migrants, indeed trafficked and smuggled people. When I worked with education for Afghan refugees in Pakistan well over a decade ago, we belatedly began to give attention to psychosocial issues; we estimated that over twenty-five percent of the refugees were so traumatised that it was difficult for them to get through the day without taking tranquilising drugs, if they could afford it, or they suffered in silence without professional psychological and somatic medical help. Most of the care was given by family members and other kind people, who had through experience, developed practical understanding of first aid and long-term care, which was all the victims got.

When the theme and focus for this year’s Mental Health Day and Week was decided, the World Health Organisation (WHO) had refugees and other migrants in mind, noting that there are more than 65 million refugees in the world today. The majority of them need psychological first aid. Each of us has a responsibility to do what we can to meet refugees and migrants with an open hand and an open heart; we must work with host governments, NGOs, and the newcomers’ own organisations.

In addition to the special focus of this year’s World Mental Health Day and Week, the overall objective is every year to raise awareness of mental health issues around the world, and to mobilise efforts in support of mental health issues. They give all stakeholders an opportunity to talk about their work, what they do and what more should be done to make mental healthcare a reality for those who need help. Indeed, it means to focus on reducing stigma related to mental health issues.

We know that many people, maybe the majority of us, will experience existential, religious and other crises sometime in our life. Then, we need first aid and professional help and care to get through the illness faster and better.

We also know that many people have inherited or congenital mental health conditions, which is certainly no fault of their own, or the way they live. If given the right help, psychologically, socially and medically, many can live better lives. And, let us get rid of the stigma around mental disorders and illnesses; the shame is on those who are ignorant and ridicule others, not on those who suffer.

In our time, with demanding, competitive and changing situations at work, school and elsewhere in society, there will be increases in mental health illnesses. Due to financial and social difficulties, including abject poverty and huge economic differences, many will feel they are losers in life and can therefore develop mental health issues which in other situations would not have happened. Also, substance dependency and abuse almost always have a mental health dimension. Sometimes, alcohol and drugs follow as a result of mental health issues that are not treated properly; at other times, people are dragged into dependency which leads to mental illness.

In Pakistan, we lag behind in the way mental health issues are addressed, which includes stigma, and indeed limited government budgets for awareness campaigns, and prevention, treatment and care of people with mental health issues. Special education is a field which is talked about but little action is taken, and that also includes lack of attention to common learning difficulties among children in ordinary classes. In every school and probably in every class, there are children who need special education support, sometimes caused by abuse at home, in the community or even at school. All teachers, in their pre-service training, should be given orientation about special education issues, so that they are in a better position to identify the children’s needs. Often, this is not difficult, but it requires training in the ability to see, and it requires that the teachers have the right attitudes and understanding.

In Pakistan, there is a huge need for greater government allocations to education and health, including mental health, and other social sector areas. Since resources are limited, and tax collection is also not good enough, we should hope for re-allocations within the state’s budgets. I believe military budgets can be reduced, in Pakistan and in most other countries of the world.

To raise allocations for mental health issues is an important task. Over time, investments in those fields will give returns to all, as will investments in general education, vocational training, special education, and other fields of the social sectors. It is wise to invest in these fields. We should remember that ten to twenty percent of us chronically or for periods in our lives, need mental health treatment and psychosocial care to keep afloat and to live better lives and contribute more to society.